“Access to medicines” is a broad concept. After a review of three authoritative frameworks that help to identify its constitutive components, this essay summarizes the actual situation on the ground in low- and middle-income countries on the basis of recent empirical work. An analysis of survey data from 36 countries concluded that developing countries should promote generic medicines as a key policy option for improving access to medicines. Taking an international perspective to that recommendation, this essay reviews the World Trade (...) Organization's Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) and, particularly, how this agreement has been applied in practice. As shown by the experience of Thailand, Brazil, and the Philippines, in order to deal effectively with international pressures for an excessive application of the TRIPS Agreement, some sort of conversion experience appears to be required, which then leads to a switch from a private enterprise, supply-driven approach to a public health vision that insists on universal and affordable access. But moral conviction is not sufficient. In order to muster and sustain the political will to face down international forces, civil society and government offices must be able and ready to show the costs and other adverse consequences of the TRIPS-based model for medicines. This calculation needs to reach beyond the health sector and calls for new alliances, nationally as well as internationally. (shrink)

When 47-year-old Simba Abalo, an unemployed retired soldier in Lomé, Togo, found out that he had AIDS in September 2007, he was unable to receive government-supplied antiretroviral drugs: “CAMEG [the state’s central medicines purchasing organization],” he said, “told me they were not taking any new cases for six months because they had run out of drugs.Stocks of antiretrovirals had become depleted after the Global Fund to Fight AIDS, Tuberculosis and Malaria suspended part of its grant to Togo in 2006 and (...) failed to approve a new grant request in 2007, reportedly because of oversight irregularities. “Even if they had the drugs,” said Abalo, “I could not have paid more than US$4 a month since I had just lost my job as a security guard earning US$70 a month.”. (shrink)

The time of art: Negri and Virno on kairòs, language, and creation. Negri and Virno aim to establish a concept of art that demonstrates a difference within a contemporary society that they see as completely dominated by the market. A time regime presenting the spheres of work and non-work as separate, structures human life. Yet in fact, work today stretches beyond the borders of both spheres. Labor power consists mainly in creativity, communication, and cooperation. Virno and Negri state that a (...) market-oriented time regime that perpetuates a divide between labor time and non-labor time presents itself as a dismeasure. It attempts to objectively measure and structure something that is really a dynamic and intersubjective matter, namely the immaterial traits that are also potentially productive of life in general, and that are productive of art. When Negri and Virno call the work of art a singular mode of labor power, they imply that it deploys the elements of labor power in a manner that is different from market-oriented labor, that it exploits their capacity to produce life itself in a meaningful way. Yet neither Negri nor Virno puts forth a broad concept of art that embodies the potential that they attribute to it. This article aims to extend Negri’s and Virno’s proposals and present a conceptualization of the nature of the artwork that would posit the difference in relation to dismeasure of the market as Negri and Virno conceive it. (shrink)

In this paper we present an executable approach to model interactions between agents that involve sensitive, privacy-related information. The approach is formal and based on deontic, epistemic and action logic. It is conceptually related to the Belief-Desire-Intention model of Bratman. Our approach uses the concept of sphere as developed by Waltzer to capture the notion that information is provided mostly with restrictions regarding its application. We use software agent technology to create an executable approach. Our agents hold beliefs about the (...) world, have goals and commitment to the goals. They have the capacity to reason about different courses of action, and communicate with one another. The main new ingredient of our approach is the idea to model information itself as an intentional agent whose main goal it is to preserve the integrity of the information and regulate its dissemination. We demonstrate our approach by applying it to an important process in the insurance industry: applying for a life insurance. In this paper we will: (1) describe the challenge organizational complexity poses in moral reasoning about informational relationships; (2) propose an executable approach, using software agents with reasoning capacities grounded in modal logic, in which moral constraints on informational relatio nships can be modeled and investigated; (3) describe the details of our approach, in which information itself is modeled as an intentional agent in its own right; (4) test and validate it by applying it to a concrete ‘hard case’ from the insurance industry; and (5) conclude that our approach upholds and offers potential for both research and practical application. (shrink)

This paper was presented at the First Conference of the ISSEI ‘Turning Points in History’, 26–30 September 1988. It belongs to Theme 1, ‘Comparative History of European Revolutions’.

Background: The Declaration of Helsinki, the World Medical Association’s statement of ethical guidelines regarding medical research, is published in the three official languages of the WMA: English, French and Spanish.Methods: A detailed comparison of the three official language versions was carried out to determine ways in which they differed and ways in which the wording of the three versions might illuminate the interpretation of the document.Results: There were many minor linguistic differences between the three versions. However, in paragraphs 1, 6, (...) 29, 30 and in the note of clarification to paragraph 29, there were differences that could be considered potentially significant in their ethical relevance.Interpretation: Given the global status of the Declaration of Helsinki and the fact that it is translated from its official versions into many other languages for application to the ethical conduct of research, the differences identified are of concern. It would be best if such differences could be eliminated but, at the very least, a commentary to explain any differences that are unavoidable on the basis of language or culture should accompany the Declaration of Helsinki. This evidence further strengthens the case for international surveillance of medical research ethics as has been proposed by the WMA. (shrink)

Positive frequency dependent selection is a natural selection regime where the fitness of a phenotype increases with its frequency in the population. Examples can be typically found in the spread of disease tolerance strategies in a population. A characterizing feature of PFDS is that the focal allele may experience favorable selection only when it becomes more frequent in the population, while being selected against when it is rare. In this paper, by applying a solution concept from evolutionary game theory, we (...) hypothesize that the process of emergence of such alleles triggers selection for silence, where the emergence of alleles that can stay unexpressed for a period of time will be favored by selection forces. We illustrate our hypothesis using a mathematical model of a population of single locus diploid organisms with two alleles where a single mutant of an allele that experiences positive frequency dependent selection appears in a population where the other allele is a dominant. The model results show that the longer the silence interval of the new mutant before its expression, the better its chances of getting fixed in the population. However, this effect will be observable only to a certain limit after which further increase in the interval will not have an effect on the expected fixation rate. Two divergences from the simple scenario are also investigated: the nonsynchronous expression of the focal allele and its emergence in a spatial grid limited by a migration bottleneck. In all cases, it is shown that there is an evolutionary pressure inherent in the dynamics of positive frequency dependent selection on the genes to have a delayed expression. It is hypothesized that the regulation systems of such traits will be under selection for either internal silencing mechanisms or to be triggered by an external environmental condition. (shrink)

Contemporary neo-liberal society is ruled by the market. Davies, Chen and Lentin and Titley show that its objectification and categorization founds a competitive notion of agency that disables subjective construction of self and intersubjective understanding of the world. As the market's rules and norms are set by white patriarchy, its competitive paradigm structurally disadvantages others. Art too is objectified and categorized by neo-liberal institutions, equally embedded in white patriarchal market structures and severely limiting democratic public access to a diverse artistic (...) field, argue hooks, Mercer and Piper. Yet, Piper's artwork shows, art holds emancipatory potential. Defined as transforming experience, its ambiguity provides a structure for constituting agentic subjectivity and intersubjective signification processes, defying objective/objectifying market workings. Photography's specific qualities allow Piper to democratize access to the paradigm she proposes. Her artistic choices may thus found the potential to publicly construct a notion of aesthetic agency as resistance to the neo-liberal market. (shrink)

Family involvement in healthcare decision-making for competent patients occurs to varying degrees in many communities around the world. There are different attitudes about who should make treatment decisions, how and why. Legal and professional ethics codes in most jurisdictions reflect and support the idea that competent patients should be enabled to make their own treatment decisions, even if others, including their healthcare professionals, disagree with them. This way of thinking contrasts with some cultural norms that put more emphasis on the (...) family as a decision-making entity, in some circumstances to the exclusion of a competent patient. Possible tensions may arise between various combinations of patient, family members and healthcare professionals, and healthcare professionals must tread a careful path in navigating family involvement in the decision-making process. These tensions may be about differences of opinion about which treatment option is best and/or on who should have a say or influence in the decision-making process. While some relevant cultural, legal and policy considerations vary from community to community, there are ethical issues that healthcare professionals need to grapple with in balancing the laws and professional codes on decision-making and the ethical principle of respecting patients and their autonomy. This paper will highlight and propose that a partial resolution to these issues may lie in relational understandings of autonomy, which in principle justify interventions by healthcare professionals and family that support patients in decision-making. (shrink)

The impact of COVID-19 on chronic pain in non-infected vulnerable South American subjects is unknown. Healthcare workers are at increased risk for CP. During the pandemic, many HCWs with CP kept working. Knowing how cognition is affected by CP in these subjects is an important subject for work safety. The attention domain has a pivotal role in cognition. Previously, the Continuous Visual Attention Test was applied to detect specific attention deficits in fibromyalgia patients. The present investigation described CP prevalence in (...) non-infected Brazilian HCWs during the pandemic and assessed HCWs’ attentional performance with the aid of the CVAT. This study was carried out at a reference University Hospital in Rio de Janeiro, Brazil. HCWs of both sexes, aged 20 or older, were interviewed from August to December 2020. A 90-second version of the CVAT was performed. The average reaction time to correct responses and the respective intraindividual reaction time variability for correct responses to target was determined. Omission and commission errors were also calculated. Then, for each participant we calculated the Z-scores of the CVAT variables based on the distribution of CVAT performance of 211 healthy subjects. HCWs with Z-scores > 1.64 were classified as significantly impaired. From the 154 selected HCWs, 72 reported CP during the pandemic. Post hoc ANCOVAs showed that the average correct VRT was significantly higher in the CP group than in the non-CP group. The percentage of participants with impaired VRT performance was 30% in the CP group and 16% in the non-CP group. The difference between these two propositions reached significance. As VRT is associated with the sustained-attention subdomain, our data suggest that this subdomain is disrupted in the CP group. (shrink)

Ideals (or ideal values) help people to navigate in social life. They indicate at a very fundamental level what people are concerned about, what they strive for, and what they want to be affiliated with. Transferring this to a leader-follower analysis, our first study (n = 306) confirms that followers' identification and satisfaction with their leaders are stronger, the more leaders match followers' ideal leader values. Study 2 (n = 244) extends the perspective by introducing the novel concept of counterideals (...) (i. e., how an ideal leader should not be) as a second, non-redundant point of reference. Results confirm that a leader's match on ideal and on counter-ideal values have independent effects in that both explain unique variance in followers' identification and satisfaction with their leader. Study 3 (n = 136) replicates the previous results in an experimental scenario study and provides evidence for the proposed causal direction of the underlying process. We conclude that counter-ideal values might be an additional point of reference that people use to triangulate targets above and beyond ideal values and discuss the implications of our findings for value research and management. (shrink)

Moral behaviour, based on social norms, is commonly regarded as a hallmark of humans. Hitherto, humans are perceived to be the only species possessing social norms and to engage in moral behaviour. There is anecdotal evidence suggesting their presence in chimpanzees, but systematic studies are lacking. Here, we examine the evolution of human social norms and their underlying psychological mechanisms. For this, we distinguish between conventions, cultural social norms and universal social norms. We aim at exploring whether chimpanzees possess evolutionary (...) precursors of universal social norms seen in humans. Chimpanzees exhibit important preconditions for their presence and enforcement: tolerant societies, well-developed social-cognitive skills and empathetic competence. Here, we develop a theoretical framework for recognizing different functional levels of social norms and distinguish them from mere statistical behavioural regularities. Quasi social norms are found where animals behave functionally moral without having moral emotions. In proto social norms, moral emotions might be present but cannot be collectivized due to the absence of a uniquely human psychological trait, i.e. shared intentionality. Human social norms, whether they are universal or cultural, involve moral emotions and are collectivized. We will discuss behaviours in chimpanzees that represent potential evolutionary precursors of human universal social norms, with special focus on social interactions involving infants. We argue that chimpanzee infants occupy a special status within their communities and propose that tolerance towards them might represent a proto social norm. Finally, we discuss possible ways to test this theoretical framework. (shrink)

We study increasing F-sequences, where F is a dilator: an increasing F-sequence is a sequence (indexed by ordinal numbers) of ordinal numbers, starting with 0 and terminating at the first step x where F(x) is reached (at every step x + 1 we use the same process as in decreasing F-sequences, cf. [2], but with "+ 1" instead of "- 1"). By induction on dilators, we shall prove that every increasing F-sequence terminates and moreover we can determine for every dilator (...) F the point where the increasing F-sequence terminates. We apply these results to inverse Goodstein sequences, i.e. increasing (1 + Id) (ω) -sequences. We show that the theorem every inverse Goodstein sequence terminates (a combinatorial theorem about ordinal numbers) is not provable in ID 1 . For a general presentation of the results stated in this paper, see [1]. We use notions and results concerning the category ON (ordinal numbers), dilators and bilators, summarized in [2, pp. 25-31]. (shrink)

The European Union Commission’s whitepaper on Artificial Intelligence proposes shaping the emerging AI market so that it better reflects common European values. It is a master plan that builds upon the EU AI High-Level Expert Group guidelines. This article reviews the masterplan, from a culture cycle perspective, to reflect on its potential clashes with current societal, technical, and methodological constraints. We identify two main obstacles in the implementation of this plan: the lack of a coherent EU vision to drive future (...) decision-making processes at state and local levels and the lack of methods to support a sustainable diffusion of AI in our society. The lack of a coherent vision stems from not considering societal differences across the EU member states. We suggest that these differences may lead to a fractured market and an AI crisis in which different members of the EU will adopt nation-centric strategies to exploit AI, thus preventing the development of a frictionless market as envisaged by the EU. Moreover, the Commission aims at changing the AI development culture proposing a human-centred and safety-first perspective that is not supported by methodological advancements, thus taking the risks of unforeseen social and societal impacts of AI. We discuss potential societal, technical, and methodological gaps that should be filled to avoid the risks of developing AI systems at the expense of society. Our analysis results in the recommendation that the EU regulators and policymakers consider how to complement the EC programme with rules and compensatory mechanisms to avoid market fragmentation due to local and global ambitions. Moreover, regulators should go beyond the human-centred approach establishing a research agenda seeking answers to the technical and methodological open questions regarding the development and assessment of human-AI co-action aiming for a sustainable AI diffusion in the society. (shrink)

© 2015 Elsevier Inc.Postnatal organogenesis occurs in an immune competent environment and is tightly controlled by interplay between positive and negative regulators. Innate immune cells have beneficial roles in postnatal tissue remodeling, but roles for the adaptive immune system are currently unexplored. Here we show that adaptive immune responses participate in the normal postnatal development of a non-lymphoid epithelial tissue. Since the mammary gland is the only organ developing predominantly after birth, we utilized it as a powerful system to study (...) adaptive immune regulation of organogenesis. We found that antigen-mediated interactions between mammary antigen-presenting cells and interferon-γ -producing CD4+ T helper 1 cells participate in MG postnatal organogenesis as negative regulators, locally orchestrating epithelial rearrangement. IFNγ then affects luminal lineage differentiation. This function of adaptive immune responses, regulating normal development, changes the paradigm for studying players of postnatal organogenesis and provides insights into immune surveillance and cancer transformation. Plaks et al. (shrink)